Study Backs 'Fit And Fat Is Fine' Argument -- But Only So Far

Researchers find overweight and obese diabetics aren't more likely to die early than other diabetics.

Fit and lean is good. Fit and skinny isn't so good. Unfit and lean is worse than fit and fat.

And fit and fat ... well, it's a whole lot better than unfit and fat, but can it be healthy? To this day, the controversial question has physicians, nutritionists, public health officials and diet gurus choosing sides.

Now a new study has added some heft to the "fit and fat is fine" argument by reporting that diabetes, not obesity, increases the risk of illness and early death.

The study was published last week in the journal Critical Care. It analyzed data from more than 15,000 participants of a government-financed study that has been running since 1987. The researchers looked at the risk of organ failure and death among overweight and obese people with diabetes, then compared it with that of all people with diabetes.

They found that diabetes, whatever a person's weight, increases the risk for future organ failure, illness and early death.

This isn't surprising because the disease is well known to be a risk factor for many health problems, including heart disease, kidney failure and blindness. But the authors also found that being either overweight or obese -- without diabetes -- added no additional risk of these outcomes.

People who are overweight (meaning they have a body mass index, or BMI, of 25 or more) do have an increased risk for diabetes, and the risk increases with size. BMI is a measure of body fat based on height and weight.

Carrying extra pounds, by some estimates, increases the risk for diabetes five- to tenfold if a person is overweight -- and even more if they are obese.

"There's a continuum," says Dr. Greg Martin, professor of medicine at Emory University in Atlanta and a coauthor of the study.

But even so, most overweight and obese people aren't diabetic, points out Dr. David Mannino, senior investigator of the study and professor of pulmonary and critical care at the University of Kentucky. He could lose a few pounds himself, he admits.

The message is tricky, Martin says. "You don't want to tell people that it's OK to be chunky," he says. *